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chemosabe
(67.172.64.173) on 7/1/2008 - 4:41 p.m. says: ( 21 views
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"Part 1 of my answer"
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CONTEXT ADDED BY ADMIN:
END OF CONTEXT
It might be best if I explain the problem in detail first. In 1997, the Republican Congress and President Clinton passed a bill which devised a formula for Medicare reimbursement called the "sustainable growth rate". In brief, this was an attempt to control the outrageous growth in Medicare expenditures by adjusting the payment for every every Medicare service down based on what the overall expenditure for Medicare was the previous year. As more Medicare services went up, the less each service was paid. Medicare services intially spiked as fees were lowered because doctors stopped doing everything and let the workload be passed around-what I mean by that is this: Instead of paying one doctor $120 to admit a patient, then $50 a day to take care of them in the hopsital, Medicare attempted to lower the reimbursement to $32. Most docs said "#badword# this" and either abandoned hospital practice altogether (and let "hospitalists" take over their inpatients) or started the trend of consulting everyone, leaving everyone in their niche.Federal regulations did not help as they increase the amount of work for everything you do by requiring a form for this (which MUST be filled out w/in an hour of ordering something etc). Now you have 3 doctors, each paid $32 a day doing what one doctor used to do for $50.
Almost immediately, everyone saw the problem with the formula- it actually INCREASED utilization of services, raised the overall cost to Medicare and made it difficult for Medicare recipients to find a doctor willing to take them in as patients. So, every year, Congress has, at the very last minute, passed a bill "freezing" the fees for the next year-or raising them a nominal amount 0.5-1%. This has gone on for ten years, until now, when the two parties began fighting over several issues, which I will explain in the next part.
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